A predictive test for difficult intubation in laryngeal microsurgery. Validation study. / Test predictivo de intubación difícil en microcirugía de laringe. Estudio de validación.
Rev Esp Anestesiol Reanim
; 64(2): 71-78, 2017 Feb.
Article
em En, Es
| MEDLINE
| ID: mdl-27592722
ABSTRACT
BACKGROUND:
In 2003 a simple test to detect difficult intubation (DI) in patients underwent laryngeal microsurgery was described. The present study was conducted to validate the test.METHODS:
Patients with laryngeal disease scheduled for laryngeal microsurgery were included. The variables evaluated were eleven parameters Mallampati Score ≥III, thyromental distance <6.5cm, mouth opening <40mm, limitation of the temporomandibular joint, pathological dentition, arched paladet, maxillary deficiency, neck mobility <90°, body mass index, symptoms of laryngeal dysfunction, and tumour of supraglottic region. A rapid examination of the airway by an expert anaesthesiologist was carried out just before induction. DI was defined by a Cormack laryngeal view gradeiii-iv and/or if auxiliary equipment was required to achieve orotracheal intubation. A comparison of ROC curves was conducted to estimate the best predicting cut-off, as well as differences between the index described in 2003 and the rapid assessment by an expert anaesthesiologist.RESULTS:
One hundred and five patients were included in the study. The incidence of DI according to the predefined criteria was 45% (47 patients). The score at the cut-off of 5 provides a sensitivity of 89% and a specificity of 55%. The fast-evaluation by an expert anaesthesiologist obtained similar sensitivity (89%) and better specificity (81%). Area under curve (AUC) was 0.87, similar to a fast evaluation (AUC 0.85; P=.71).CONCLUSION:
The index was validated at a cut-off of ≥5, being a useful and reliable test to predict DI in patients with laryngeal diseases and it is a useful tool for anaesthesiologists with conventional training.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Índice de Gravidade de Doença
/
Antropometria
/
Obstrução das Vias Respiratórias
/
Manuseio das Vias Aéreas
/
Intubação Intratraqueal
/
Laringe
/
Microcirurgia
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Humans
Idioma:
En
/
Es
Ano de publicação:
2017
Tipo de documento:
Article